Individual
MAXWELL GOODMANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
360 SHERMAN ST STE 160, SAINT PAUL, MN 55102-2425
(651) 291-9000
Mailing address
360 SHERMAN ST STE 160, SAINT PAUL, MN 55102-2425
(651) 291-9000
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
1104163187
MN
Other
Enumeration date
08/31/2021
Last updated
09/07/2021
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